Diagnostic Criteria and Characteristics of Spinal Cord Infarction

Spinal cord infarction is an underrecognized etiology of myelopathy that is sometimes misdiagnosed as transverse myelitis (NEJM JW Neurol Mar 2018 and Neurology 2018; 90:e96). Investigators reviewed data from 133 adults (median age, 60; interquartile range, 52–69) with spontaneous spinal cord infarction in the past decade at one institution.

Nadir was reached within 4 hours in 56% of patients, within 4 to 12 hours in 21%, within 12 to 24 hours in 14%, and beyond 24 hours in 10%. A stuttering or stepwise decline was more common with presentation past 8 hours. Selective pain and temperature sensory loss was present in 39%, severe back/limb pain in 72%, and one or more vascular risk factor in 76%. Lumbar puncture showed mild elevation in white …